I think my Ptosis is worse after surgery. What do you think? (photos)

Question

Hello I had gotten ptosis surgery about 7 months ago and in my opinion it's worse. Even when I look down or tilt my head up or if someone is shorter than me they will see it too. I took picture of looking at it straight,above,and below. I would really like your opinion of what I should do. They also said if it didn't work first surgery they will do it again. Thank you very much.

John J. Martin, Jr., MD · Answer

You have a ptosis of the right upper lid.  Can't comment on whether it is better or worse than pre-op since you didn't post photos of the before.  When the lid is still low after 6 months you can do a revision.

Katherine Zamecki, MD, FACS · Answer

It would be helpful to see a pre-operative photo to see the comparison before and after surgery. It looks like the right upper eyelid is still a little low.  At seven months post-operatively, there is no more swelling. This is an under correction of the ptosis, which happens. The contour and lid crease are nice. If you are not happy with the appearance and the vision is still being obstructed by the drooping, a revision can be considered. A revision may be approached from the skin surface (anterior) or posterior surface, depending on which one will yield a better result. There will be scar tissue with which to deal with, making a revision a little more difficult than the primary surgery. Make to sure to see an oculoplastic surgeon with a lot of experience with ptosis surgery. Good luck!

Tracy E. McCall, MD · Answer

Go back and talk to your surgeon. You do appear to have ptosis on the right. So long as your eyelid scar appears to be soft, usually at least 6 months, you should be able to get a revision. Good luck.

Sara A. Kaltreider, MD (retired) · Answer

Very difficult to say what might be happening with your eyelids. Residual ptosis is evident more on the right than the left. The downgaze suggests some retraction. I'm wondering if you have a congenital ptosis or myogenic ptosis rather than a simple levator dehiscence - your surgeon should be able to answer these questions for you. If not - seek an opinion from an experienced oculoplastic surgeon in your area. Best wishes.

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